Bush unveils $7.1 billion avian flu plan

WASHINGTON—Sounding the alarm against a possible global flu pandemic, President Bush on Tuesday asked Congress for $7.1 billion in emergency funds to help prepare the country for a possible outbreak of the deadly avian flu.

The flu virus, H5N1, is highly lethal, and while it doesn't spread easily to people, human beings have virtually no immunity. If the virus mutates into a form that passes easily among humans, it could kill millions of people around the world. The virus is continually evolving, and the number of countries where birds are infected and come into contact with humans continues to increase.

The president's announcement was short on details, but signaled the administration's strongest response yet to what many fear could be the worst threat to public health in nearly a century.

More details are expected in a Health and Human Services report due out Wednesday, and most experts reserved judgment until then.

"Right now we have a list of goals from the president and we'll have to see if there's an actual plan on how to get these done," said Dr. Thomas Inglesby, deputy director of the Center for Biosecurity at the University of Pittsburgh Medical Center. "We need to know more than just the `whats.' We need to know the `hows.'

Speaking at the National Institutes of Health in Bethesda, Md., Bush called for stockpiling enough bird flu vaccine to protect 20 million Americans, a goal that wouldn't be met until 2008 or 2009. He also called for research into new technology that could speed up vaccine production.

"There is no pandemic flu in our country or in the world at this time, but if we wait for a pandemic to appear, it will be too late to prepare, and one day many lives could be needlessly lost because we failed to act today," Bush said.

Bush called for:

_tracking the spread and changing nature of the H5N1 virus both internationally and in the United States;

_increasing the stockpile and U.S. production of flu-fighting medications;

_coordinating federal, state and local response plans;

_and providing better public information about the flu.

He also called for Congress to approve $2.8 billion to develop cell culture technology, which would make it possible to produce vaccines much faster than the current 50-year-old technology, which produces vaccine from chicken eggs.

The president also sought $1 billion for 81 million full treatments, or courses, of the antiviral medications Tamiflu and Relenza, which reduce flu symptoms. Of that amount, 44 million would go to the federal stockpile, 31 million to state stockpiles and 6 million for emergency use if the avian flu begins spreading from person to person.

But it's unclear how soon those medications can be delivered because other countries placed similar orders months earlier.

In addition, Bush called for $1.2 billion to purchase 20 million courses of the H5N1 vaccine. But it will likely take three or four more years to complete the order, a senior White House official said.

"That's a big problem and it's basically unacceptable for that to be the timeline," said Inglesby of the University of Pittsburgh Medical Center.

On Wednesday, Health and Human Services Secretary Michael Leavitt will release the department's national flu plan that provides guidance for state and local governments on how to prepare and respond to a flu pandemic. Each state has already submitted a pandemic flu plan to the Centers for Disease Control and Prevention, but Leavitt said recently they were not adequate and would likely need to be revised.

On Tuesday, the president proposed $100 million to help states improve their plans, but that probably isn't enough, said George Hardy, executive director of the Association of State and Territorial Health Officials, which represents state public health agencies. Hardy said the president's 2006 budget proposal cuts $130 million from state and local health departments.

"We're pleased the president is taking this seriously, but what's important to us is the details of the plan that comes out of HHS tomorrow," Hardy said.

Patrick Libby, executive director of the National Association of County and City Health Officials, had similar concerns about whether the HHS plan calls for additional resources to help local agencies test for the virus and investigate how people became infected with virus. "We need to see how that is reflected in the HHS plan," Libby said.

Experts warn that the avian flu has the potential to be more deadly than the Spanish flu, which killed more than 50 million people in 1918. A pandemic could force schools and businesses to close, disrupt the supply of food and other essential goods and leave hospitals and morgues overwhelmed.

People who would likely get the vaccine first include health care workers, people working on the nation's borders, those who work on international aircrafts and agriculture industry workers, said Rajeev Venkayya, Special Assistant to the President for Biological Defense Policy.

To date, 122 people in Southeast Asia have contracted the flu, mostly from chickens or other birds, and 62 have died, a mortality rate of 51 percent, according to the World Health Organization.

The Bush plan seeks $251 million to train personnel and expand testing for the virus in countries around the world.

Bush also called for legislation to relax liability laws that keep U.S. drug makers from entering the vaccine market.

So far, the United States has stockpiled only 2.3 million full treatments of Tamiflu, which is made by the Swiss drug company Roche. That's enough for less than 1 percent of the population. France and Britain, by contrast, have enough to treat 25 percent of their population. The United States has also stockpiled 84,300 courses of Relenza, another anti-influenza drug.

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For more information about the Avian flu, go to a new government Web page at www.pandemicflu.gov